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Archive for the ‘Medical Malpractice’ Category

Is Non-Party Witness Entitled to Attorney at Deposition? (Appellate Court Says No)

Friday, February 26th, 2010
The idea that a witness testifying at a deposition would not be entitled to have an attorney is somewhat startling. But that is, in fact, what the Appellate Division, Fourth Department held earlier this month in Thompson v. Mather, when they firmly established that "counsel for a nonparty witness does not have a right to object during or otherwise to participate in a
pre-trial deposition."

The issue arose during a medical malpractice case involving obstetrical and gynecological treatment and the prescription of oral contraceptives. Plaintiff claimed they were contraindicated. The patient suffered an acute myocardial infarction.

Plaintiff wanted to video the testimony of the treating cardiologists, who were not defendants. The doctors showed up with lawyers provided by their own medical malpractice insurers, who then proceeded to obstruct the questioning. The deposition was abandoned and motion practice ensued.

The lower court, in one of the most bizarre rulings I've ever heard of, suggested that these doctors who had never been sued should be released from liability before unrestricted testimony was to take place! The court suggested that plaintiff and defendants are to
"consider providing general releases to the [physicians] . . . with respect to their initial treatment of [plaintiff]" and that, if such releases are provided, plaintiff will "be entitled to have a videotaped deposition of [the physicians] during which deposition the attorneys for the [physicians] shall not be permitted to speak. . . ."
Holy mackerel. In reversing the lower court, the Appellate Division called that "repugnant."

But first they addressed the issue of having counsel at the deposition, and came down firmly against it. Why? Because CPLR 3113 (c) provides that the examination and cross-examination of deposition witnesses "shall proceed as permitted in the trial of actions in open court." The parties can object later, but the witness isn't a party. If this was a trial, the witness would not have a lawyer in the well of the courtroom to object.

And then they kicked the lower court judge but good with respect to that nonsense about providing a release to a witness before testimony could ensue:
...we note that the practice of conditioning the videotaping of depositions of witnesses to be presented at trial upon the provision of general releases is repugnant to the fundamental nonparty obligation of every citizen to participate in our civil trial courts and to provide truthful trial testimony when called to the witness stand. Contrary to nonparty respondents' contention, the fact that the statute of limitations has not expired with respect to a nonparty treating physician witness for the care that he or she provided to a plaintiff provides no basis for such a condition.
The unanswered question that I have, given that the lawyers for the cardiologists were provided by their medical malpractice insurance carrier. Is it the same carrier as the defendants?

And that question was answered by one of the attorneys involved: No. But certainly something to look for if the situation should arise elsewhere, as may well happen with this ruling if such non-party depositions become more common.

New Michigan Malpractice Rule

Thursday, February 18th, 2010

The Michigan Supreme Court issued an order requiring defendants in medical malpractice lawsuits to challenge deficiencies in Plaintiff's attorneys’ notice of intention to sue and certificate of merit within 63 days of service. This rule also applies to challenges of the qualifications or eligibility of the signer. (The court did allow an "except for good cause" which may lead to a lot of litigation over just how much discretion judges will have with respect to what constitutes good cause.) Perhaps more importantly, an amendment to a certificate of merit now relates back to the original date of the filing of the affidavit.

One problem this rule is intended to rectify is when defendants’ malpractice lawyers intentionally sandbag potentially legitimate objections until after limitations passes and then try to get the case kicked for some procedural deficiency. Now, malpractice plaintiffs with procedural deficiencies can amend so that the statute of limitations does not pass. In other words, substance triumphs over silly procedural nonsense. In my world, this is a good thing.

Depressingly, the short AP story on this ruling characterizes the case in partisan terms that would hit an odd cord with any Maryland lawyer unaccustomed to the injection of party affiliation in reports on appellate court rulings:

Republican Elizabeth Weaver joined Democrats Marilyn Kelly, Michael Cavanagh and Diane Hathaway in supporting the change in the order issued Wednesday. Republicans Maura Corrigan, Robert Young and Stephen Markman opposed the change.

I think I could accurately predict how each Maryland Court of Appeals judge voted in the 2008 presidential election. Still, we are blessed in Maryland to be able to largely keep judges’ voter affiliation and raw politics out of appellate decisions. The difference is that Michigan elects their judges which pushes politics to the forefront. The lesson, as always: judicial elections are foolish. (Parenthetically, retired Baltimore County Judge Dana Levitz made a great argument against judicial elections in the last issue of the University of Baltimore Law Forum. I wrote about the insanity of judicial elections four years ago here and last year here.)

One of the dissenting opinions gets incredibly personal in its attack, arguing that two of the judges contradicted their own positions taken in administrative conferences, encouraging interested parties to go back and watch the online video of the conferences. You would never see this in a Maryland appellate court or a Supreme Court opinion. I had no idea of how civil we are in Maryland until I read this opinion.

You have to read the entire opinion. You can find it here.

Defensive Medicine

Wednesday, February 17th, 2010

In the Tennesseean, an emergency room doctor admits to performing unnecessary tests to avoid malpractice lawsuits:

In my personal practice, if I knew that I couldn't be sued except for things that I truly believe I should get sued over, I could eliminate half of my lab tests, two-thirds of my X-rays and 90 percent of my CT scans because all of those tests are done for my protection, not the patient's.

In other words, this doctor admits to ordering tests that can harm and cause risk to a patient - as CT scans and x-rays certainly do - for his own protection to avoid a malpractice lawsuit for which he has insurance.

I'm not sure what is more depressing, the fact that the doctor blithely admits this to a reporter thinking it is an acceptable medical practice to put his own interest ahead of the patient or the fact that there will be no ramifications for this doctor. If a lawyer or an accountant made the same admission - that he/she put their interests first ahead of their clients - the Internet would explode.

Thankfully, the vast majority of doctors put their patients first.

Federal Malpractice Cap

Wednesday, February 17th, 2010

Let's say Barack Obama decides to take a strong position on medical malpractice caps and puts his weight behind a bill to eliminate malpractice and other damage caps in all 50 states.

This would be a huge windfall for our practice. But I would oppose this legislation. Why? Because such a law would be a ridiculous intrusion into the affairs of the States by the federal government. The federal government has no business telling the states they cannot have caps on damages. (I think caps violate state constitutions because they are a legislative intrusion on the separation of powers every state has in its constitution. But that is a different blog post.)

How, then, can tort reform advocates - who are almost to a person far more 'States rights, get government out of our lives" than I will ever be - support this unprecedented intrusion of caps on damages in medical malpractice cases via a health reform bill? It is because most tort reformers have a world view: lawsuits are bad, caps are good. They will push for this goal by all means necessary, including shedding inconvenient authentic core values.

Did Rep. John Murtha Die From Medical Malpractice?

Tuesday, February 9th, 2010

Rep. John Murtha (D-PA) died yesterday, a week after routine gall bladder surgery (cholecystectomy). He was a powerful congressman with his finger on the button of Pentagon appropriations.

And with his high-profile death comes an opportunity to explore some medical malpractice issues.

So let's do this in Q & A form:

What is the first reaction as to why this happened?

First up is the most common reason for malpractice litigation with gall bladder surgery: That the common bile duct was mistakenly cut. I don't know what happened here, of course, since I don't have the medical records or the autopsy results, but you can bet that is one of the first places people will look.

As basic background, the liver produces bile that helps us digest. It is transmitted to the intestines via ducts. The gallbladder stores bile. A schematic is seen here at left.

Was this due to infection, instead of a common bile duct injury?
Some are claiming that the death occurred because the intestine was mistakenly cut during surgery, and that this caused an infection. Someone investigating the case would then naturally ask the following questions:

Was the cut intestine noticed during surgery, and if not, why not? Cutting something that you're not supposed to cut is one thing. But failing to notice that it was cut is a whole different thing. This is often the dividing line between when a malpractice case is successful or not. Bad results by themselves don't mean malpractice. Failing to recognize mistakes, however, is a different concept entirely.

If noticed during surgery, what was the response? This surgery was done via a laparoscope, in which the scope is passed through a small incision, with surgery done with a camera-assist. Depending on when and where the bad surgical cut happened, and whether it was noticed at the time, the logical questions are who, if anyone, was called in to assist in the repair and how was it done?

When were the first signs and symptoms of infection noticed and reported and what was done about it? If the cut was noticed during surgery, then in addition to any potential antibiotics that may have been given, would have been very strict discharge instructions to the patient on the signs and symptoms of infection and the critical nature of prompt action.

If this is a known risk of the procedure, why blame the doctor?
This one is a classic, and defendants love it in the courtroom. But it is the wrong question to ask. The issue is not whether something was a known complication or risk, but whether it was avoidable with good care.

Think of it this way: Is a car accident a risk of driving? Does the fact that accidents are a risk of driving mean that the guy who ran the stop sign is not responsible?

Was Murtha just one of up to 98,000 estimated deaths from malpractice in the US each year (Study: To Err is Human)? Time will tell on that one. And we will see to what extent if death has an effect on the health care debate in Congress and the desire by some to grant certain immunities to the medical industry for malpractice.

On a last note, not only was Murtha deeply involved in political-military issues, but the surgery took place at the National Naval Hospital in Bethesda, MD. This adds another potential political element to any investigation or legal action in the event that family moves in that direction.

Baltimore Sun on Malpractice Courts

Monday, February 8th, 2010

The Baltimore Sun continues to push the idea of medical malpractice cases being placed into some sort of health court. Naturally, as is their practice, the Sun offers no real details and no balance to the editorial besides blaming trial lawyers for everything but the Blizzard of 2010. More problematically, they support a solution without really identifying a problem. What is the evidence of a problem with the judges that are currently handling medical malpractice lawsuits in Maryland? This would seem to be a prerequisite to offering a solution.

The Sun thinks that the governors of this state have nominated judges that cannot understand how to administer medical malpractice lawsuits. Either this is nonsense or we have a gubernatorial malpractice claim against Governors Mandel, Hughes, Schaefer, Glendening, Ehrlich, and O'Malley. I'm going with the nonsense theory myself. It is also silly to suggest that doctors are so vested in this idea. Even if trained malpractice judges are better malpractice judges, I don't think anyone has any idea of whether having malpractice specific judges is going to help plaintiffs or the doctors' lawyers in discovery or at trial.

The Sun goes on to tout the importance of a new "I'm sorry" law so doctors can admit they screwed up. On its face, it sounds okay. There is evidence that patients and their families benefit when doctors disclose medical errors and apologize. But did we do a study as to how these same patients feel when these apologetic doctors admit to their patients what they did but then can make a farce of that admission by denying it publicly later? Will this make a mockery of the victims and the court who sanctions what is going to approach or reach perjury?

The reality is a sympathetic "I'm sorry" when any professional (or even the other driver in a car accident) makes a mistake is going to make it less likely that the victim is going to bring a claim. Doctors should say they are sorry because it helps the patient, themselves and because it is the right thing to do, not because they are given immunity for the apology.

I also don't think the law is going to make much difference. Good, decent doctors (the vast, vast majority) will apologize if they think they make a mistake. Doctors that won't because they fear malpractice probably wouldn't apologize anyway.

Medical Malpractice Case: The Emma Mejias Story

Sunday, February 7th, 2010

http://www.insiderexclusive.com/show-titles/120-medical-malpractice-case-the-emma-mejias-story-

Emma Mejias died a horrible and painful death, on her very first Christmas Eve in 2004, at the hands of 25 doctors and nurses, another victim of medical malpractice. All 25 of them systematically and willfully ordered and administered the wrong drugs for her life-threatening condition called SLOS (Smith Lemli Opitz Syndrome). SLOS is a congenital abnormality, which requires treatment strategies on supplying supplemental cholesterol. Emma was given the Wrong Drug, Questran, not once, but 92 times – yes, 92 times in one month. All of the doctors and nurses knew better.  They were trained to know better. They were some of the world’s leading authorities at the LSU Health Sciences Center in New Orleans. And her doctors had the unmitigated gall to blame Emma’s death on the new resident doctors, rather than take responsibility themselves. Emma remained hospitalized at various hospitals from the date she was born to the day she died, because of the outrageous medical malpractice perpetrated on her by 25 so-called health care professionals, none of whom cared enough to give her the potentially life-saving medical treatment she desperately needed. She suffered enormous physical pain and suffering prior to her death. Today, for the very first time ever on TV, The Insider Exclusive will visit with both Jason and Adrienne Mejais and their lawyer John Hammons, Partner at Nelson & Hammons, who for 30 years has been standing up for people like Emma, a little innocent baby, who never had the chance to stand up for herself.

John Hammons is one of Louisiana’s leading medical malpractice and nursing home negligence lawyers, and is often called upon by individuals as well as by other lawyers to assist them in the most difficult of cases. He has served on the Governor’s Commission on Medical Malpractice, which provided him with significant insight in this area of developing law. John was also among the first lawyers in Louisiana emphasizing the handling of medical malpractice cases three decades ago. He has been at the forefront of precedent-setting cases, and is often invited to speak before legal and medical groups. John holds an undergraduate degree from Northeast Louisiana University and a law degree from Louisiana State University.

Nelson & Hammons has championed the rights of victims of medical malpractice since 1980, having successfully represented hundreds of such patients or their families. With its office in Shreveport, Nelson & Hammons remains committed to quality medical care for its clients and their families as well as obtaining just compensation for those patients who have been seriously injured as a result of substandard medical care. With two attorneys specializing in the handling of medical malpractice, nursing home negligence and related matters, Nelson & Hammons is uniquely positioned to effectively and thoroughly investigate and prosecute such cases.

You can contact John Hammons at 318-227-2401, or www.nelsonhammonslaw.com

Illinois Malpractice Cap Ruled Unconstitutional

Friday, February 5th, 2010

The Illinois Supreme Court made big news nationally when it issued its much awaited opinion in Lebron v. Gottlieb Memorial Hospital yesterday, The court overturned in a 4-2 ruling the Illinois five-year-old medical malpractice cap on damages because limiting compensation for injured malpractice victims for pain and suffering violated the Illinois constitution.

Specifically, the court found that the Illinois malpractice cap violated the “separation of powers” clause because imposing a cap imposes on a decision that should be made not by legislatures but by juries.

The underlying lawsuit involves a catastrophic birth injury. Plaintiff’s lawyers alleged the infant Plaintiff’s severe cerebral palsy was caused by the negligence of the hospital, her obstetrician, and a nurse.

The appellate path taken in this case was atypical. Plaintiff sought summary judgment on the issue of whether the cap applied, which the trial court granted before the case was tried. Procedurally, this is odd and the dissenting opinion took exception to the idea of deciding this case without a verdict. I understand the dissent’s thinking on this. But the parties at least are best served taking this path because they both know how the law is going to be applied. This makes the case much easier to settle and settle fairly whichever direction the court takes. After the trial court’s ruling, the Defendants appealed directly to the Illinois Supreme Court.

Essentially, the court found that a cap on damages is a legislative remittitur and the failure to leave the issue of remittitur to the court which decides the issue on a case-by-case basis represents legislative intrusion on the powers vested in the court by the Illinois constitution.

One favorite part of the opinion for me was the way the court responded to the defendant’s argument that other states had damage caps: “That ‘everybody is doing it’ is hardly a litmus test for the constitutionality of the statute.”

St. Joseph’s Stents and Lawyers

Friday, January 29th, 2010

The Baltimore Sun has an interesting article on the race among lawyers to attract St. Joseph stent lawsuits that includes some quotes from me.

St. Joseph’s Stents and Lawyers

Friday, January 29th, 2010

The Baltimore Sun has an interesting article on the race among lawyers to attract St. Joseph stent lawsuits that includes some quotes from me.